Brachioplasty after massive weight loss: analyzing wound healing and risk factors for dehiscence.

[BACKGROUND] Brachioplasty in the post-bariatric patient deserves special attention since a not negligible number of wound complications is reported in the literature. In this study, the authors present unique risk factors for wound dehiscence and delayed wound healing based on retrospective data in post-bariatric patients who underwent brachioplasty alone or with other procedures.

[METHODS] A total 31 patients who underwent brachioplasty alone or combined with other procedures between 2017-2022 were included. Data analyzed encompassed demographic information, biometric data, type of brachioplasty if performed alone or in combination with other procedures, days to epithelization/closure, and its management.

[RESULTS] A total of 15 patients (48.38%) experienced surgical wound dehiscence, the majority (66%) being minor wound dehiscence. Subjects who underwent concomitant arm liposuction with brachioplasty showed a higher degree of dehiscence (P = 0.021) and more days to epithelialization/closure (P = 0.10). Fifty-seven percent of patients who underwent a combined procedure showed some degree of dehiscence, as well as more days to epithelialization/closure (41 vs 15.75 days). Brachioplasty and mastopexy as combined procedures demonstrated more days to epithelialization/closure (P = 0.05).

[CONCLUSIONS] Brachioplasty in the post-bariatric population is deemed safe and effective; nevertheless, it carries an increased risk of wound dehiscence and delayed wound healing when combined with liposuction and other procedures. The plastic surgeon needs to become familiar with variables that increase the risk of this complication, all of which can be anticipated in preoperative planning.